What are doctors' ethical obligations when providing medical care to hateful patients?

There hasn’t been a whole lot written in the American press about the story of an unidentified German doctor who walked out of surgery when he saw a swastika on the arm of his already anesthetized patient. (According to The Telegraph‘s translation of an article in the German daily Suddeutsche Zeitung, the doctor said, “I can’t operate on this man. I am Jewish.” The BMJ‘s translation has a slightly more poetic ring to it–“I cannot operate on this man. I am a Jew”–but their piece is also stuck behind a typically absurd medical journal paywall.)

The unidentified surgeon found a colleague to take his place, and while he was the subject of a lot of public criticism, he was not reprimanded.

I’m not a doctor — I had to give my cat a subcutaneous injection of 50ml of fluids about an hour ago and I almost passed out — but the surgeon’s argument that he hadn’t violated his ethical obligations as a physician seems to me to be a bit absurd. This is not someone who refused to treat a patient in advance…it’s someone who walked away from an unconscious man on the operating table. How does that jibe with following line in the Hippocratic Oath?

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

I understand the attendant issues are vastly different in Germany — where displaying Nazi symbols is illegal and can land you in jail for up to three years — than they are in the US. (I also understand the inherent dangers of relying on translated news articles when coming to snap judgments.) So instead of thinking about this as a real case, let’s think about it as a case study: If there are any doctors out there, what do you think…and what would you do?

Also not a doc, but I hope in a situation like that I’d consider that views can change but tattoos are (more or less) permanent. The guy might have long since repudiated whatever sentiments prompted him to get the tattoo. There might have been other visual cues that would make this more or less likely.

In the general case, I think it’s the honorable thing for a professional to subjugate his/her feelings to the needs of the client, but not an absolute ethical mandate. If the pro’s convictions can be accommodated without risk to the client, I’d have a hard time getting too worked up about it. Especially with the nuance Garance suggests (the pro may be so disturbed as to compromise his/her performance).